(So my two boys and I play a game where they ask me to explain things as if I am the Smartest Dad in the World – which really means, “with the wackiest obviously-fake explanations possible.Usually they humor me by pretending that they’re impressed…until today.)

Cranquis: Well corn flakes come from the scales of the corn armadillo, which is a rare animal found only in the jungles of Iowa.

Younger Son, age 4 (stage whisper to his older brother): I don’t think I can believe that. I mean, I will if I have to, but it’s silly.

Embarrassingly I still do this (I work at my hometown hospital where I was a junior volunteer during high school, did several rotations at and, I’ve been working as a PA now going on 6 months). Especially when I walk out of elevators. Sometimes I do the “let me pull out my cell phone and pretend like someone just texted me to meet them and that’s why I got turned around” thing.

Oh dear hahahahahahha

At my base hospital, they make all the floors look pretty much the same and in the center of the two wings is the computers… I always walked the wrong way.,.. :/

THE NIGHT BEFORE CRANQMAS, BY DR. CRANQUIS
‘Twas the night before Cranqmas, and all through the Urgent Care
Not a creature was stirring: no patients were there!
We’d been very busy but now it was Q-word.
(That’s “Quiet”, but we don’t dare announce it, ya’ heard?)
The staff were slumped over, worn out, in their chairs;
While visions of leaving on time danced through the air;
And Nurse in her smock, and I in my scrubs,
Had just called the pizza place to order some grub,
When out in the waiting room there arose such a clatter,
I sprang from my chair to see what was the matter.
Away to the window I flew, lickety-split,
Just in time to see some guy throw up through it.
The emesis on the breast of the still-heaving guy
Was black and smelled like something had died.
I glanced to the parking lot to see how he got here:
Just as I thought: he’d ridden a John Deere.
He slurred out his name in an accent so thick,
I didn’t quite catch it, so I nicknamed him Old Nick.
More rapid than eagles his retches they came,
And he wheezed, and he shouted, and he called us bad names:
“Now, ****er! You *****er! I’ll *** your ****!
Give me some Dilaudid, you **********!
Whaddaya mean, "Do I drink alcohol?”
I had a fifth of vodka today, maybe 2, that’s all.“
Now quick for an emesis basin my skillful nurse flew,
As the barf hit the floor, and Old Nicholas too.
And then in a twinkling, the emesis turned bright red –
Esophageal rupture: this dude was half dead!
As I reached for the phone and called 911,
He slumped to the floor – (oh joy, here comes the fun).
His eyes were so jaundiced! His breathing so shallow!
His cheeks and his nose pale as a marshmallow!
He had palmar erythema and a distended belly
That shook when he retched, like a bowl full of jelly.
Classic alcoholic cirrhosis, with Hep C probably,
So I pulled on some gloves to hopefully protect me.
A feel of his pulse, which felt thin as a thread,
Soon gave me to know I had plenty to dread;
He spoke not a word, just continued to hurk,
As we placed 2 IV’s and tried to make his heart work,
His blood pressure dropped as mine steadily rose,
But hark! Ambulance sirens! So glad to hear those!
The EMTs snatched him, slick as a whistle,
And away they all flew like the down of a thistle.
But then I heard him exclaim, as they drove out of sight—
“Hey it’s Cranqmas, y'all – can I have a Bud Light?”

it’s waking up from a restless night of sleep, bracing yourself to face the day.it’s willing your body to make it two more steps, so you can brush your teeth.it’s compromising looking decent for having a bit more energy.it’s realizing how tired you are…and it’s only nine in the morning.

it’s trying desperately to focus on your professor’s words.it’s constant shifting to try and get a bit more comfortable.it’s holding back the tears as you remember that meeting.it’s nap time, because without it you would collapse.

it’s telling people no, not because you don’t want to but because you can’t.it’s always feeling like you’ve let someone down.it’s nagging pressure to try and act normal.it’s your body shutting down when you do that.

it’s a phone book’s worth of doctor’s office numbers.it’s lab work every month.it’s eight, ten, twelve pills a day (or more).it’s hoping and praying that this new treatment is effective.

it’s looking normal but knowing you’re not.it’s judgmental glares from strangers when you take the elevator, not the stairs.it’s misunderstanding from friends who truly do care.it’s not fair, but you deal.

it’s giving up the life you thought you’d have because you can’t physically do it.it’s seeing other people happy and healthy and wanting it for yourself.it’s emotional and physical pain, twenty-four seven.it’s wishing it would all go away.

it’s hearing you’ll never be able to have children.it’s feeling inadequate and invisible.it’s wanting what you’ll never have.it’s the worry that something else will pop up.

it’s fibro and lupus and hashimoto’s and crohn’s.it’s CFS and PCOS and CAH and RA. it’s endometriosis and celiac and cushing’s and MS.it’s chronic illness, and it’s your life.

***

i promise i’m not depressed; well, at least not in the sense that i’m gonna go and do something cray. no, i have a strong support system and for that i am eternally grateful. but it’s been a rough week. i feel as if i went from the mountain top last week to the darkest valley this week - and it is all because of my stupid immune system.

invisible, chronic, autoimmune illness has plagued my life. there are some days when i say that everything is going to be alright, that i’m alright, that it’s just another thing, that there is medicine for that. then there are some days, like today, when i’m so spent i can’t even make it out of the apartment. i use up the little energy i have on homework and have nothing left for friends.

one thing that i’m learning - and that my mom reiterated to me earlier today - is that i have to stop worrying so much about what other people think, because it’s not their body that pays the price for me pushing myself too hard. and she’s right. as whiny as it may sound, any person with chronic illness can tell you that if you push yourself just a bit too much, you pay for it the next day. and it takes a while to pay for it, because it creates this snowball effect of trying to catch up on the stuff you miss while you’re paying for pushing yourself too hard, and the vicious cycle continues.

i just want so desperately to lead a normal life, but that is an impossibility. the only thing i can do is make the most of what i have, and learn to love myself, to take care of myself, and to be all i can be.

this all happened for a reason, i’m sure of it.one day i’ll know.

for now, while i try and conserve the spoons i have left, i thank God for specialists who seem to know what they are doing (even though i had to go through some crummy ones first) and for my support system, those loved ones who never fail to make me smile, even on the dark days.

You guys are the jam, for real. I woke up around 2am last night from nervousness about the Big Scary Thing today and as I was perusing tumblr, I found the start of the Wayfaring Appreciation posts. Y'all really made my day. All day I saw new ones popping up and they really cheered me up. So thanks for being so awesome. In return, I thought I’d share my appreciation for some of my followers:

Posts A LOT, which is great when I’m bored and want to see funny stuff but is problematic when I’m trying to catch up on back-posts.

She’s Greek. Like reeeaaallyy Greek. Like Toula was Greek in My Big Fat Greek Wedding. Which happens to be a fave of mine, so I picture her as Toula in my mind when I read her blog even though she occasionally posts her face.

Is a big proponent for understanding among people of different faiths, which I love.

Cranquis: Well, I have bad news and good news. The bad news is that you probably have another one on your right side just like it. The good news is, they’re your 12th ribs and they’ve been there all your life.

It appears that my Tumblr star has started to shine a bit, thanks to the Nonny who noticed that I have reproduced a bit above the average. I woke up this morning with SO MANY notifications and I wondered, “Is this what it feels like to be @cranquis?” So thanks for my 15 minutes. It’s been dreamy.

Husband of patient with glass fragment in foot [excerpts of his constant teasing throughout entire visit and procedure]: “HEH THAT’LL TEACH YOU TO WALK AROUND BAREFOOT. HEY DON’T BLAME ME I DIDN’T DROP THAT CUP ON THE FLOOR. OOH THAT LOOKS LIKE A BIG NEEDLE I BET THIS IS GONNA HURT. YEAH THAT’S GONNA LEAVE A SCAR FOR SURE, YOUR FOOT MODELING DAYS ARE OVER.”

Cranquis throughout:

Cranquis giving discharge instructions: “…now when you change the dressing, wash the wound carefully. Studies show that foot wounds heal faster if your husband kisses them regularly, but you could also apply bacitracin and…”

Hi Wayfaring! My sister is graduating from med school on Friday. She matched into a great family medicine residency. I'm super proud. Any thoughts on what would be a good semi-useful graduation gift for the starting intern?

Ooh I like this question! I’m a pretty practical person so most of my suggestions will be practical things, but things people appreciate nonetheless. I’m purposefully not putting any medical stuff here. Her life will be full of medicine. Get her something else. Her residency program will give her an allowance for books and coats and such, so don’t waste your $$ on those.

K, here goes:

Subscription or intro month to one of those services like Blue Apron or Hello Fresh that sends you all the stuff to make a fancy meal once a month or something. Residents don’t cook right most of the time.

Massaaaaaahhhhge. Or Acupuncture. Whatever your flavor is. She will need a session to relax those tense muscles at some point in her intern year.

Car wash coupons. Sounds lame, I know, but a friend gave them to me for Christmas one year and it was awesome because I NEVER paid to get my car washed before. A clean car makes you feel better about your life.

Get her car serviced. Oil change, new fluids, belts, whatever. She ain’t gone have time for it once she gets started in residency.

Starbucks gift card. Because @cranquis and I are the only doctors in America who don’t drink coffee.

Coloring books. For real tho. They’re so relaxing. She’s going to need something to do during those times she’s stressed out and doesn’t want to use her brain.

Birchbox subscription. Bacon of the month (I got that once for like 6 months and it was AMAZEBALLS). Doggy treats of the month. Wine of the month. Dollar shave club. Something of the month. It’s nice to get a fun package every month. And she will forget about it every month and be surprised every time she gets one.

Pay for a maid to come clean her apartment/house at some point in residency. Probably in January of intern year. January is the worst.

Houseplants. Everyone needs something alive in their house to brighten it up. Succulents, african violets, and kitchen herbs are easy to grow in a windowsill, easy to keep alive, and are usually pet-friendly too.

A trash magazine subscription. She’s going to have to read a bunch of boring crap. Help her stay up to date on the things that really matter like who Taylor Swift’s current boyfriend is.

A really good quality pillow and a face mask or blackout curtains. Night shifts are the worst. Help her sleep better.

Aromatherapy. Candles, spray, whatever. In calming scents. One of my friends used to spray her call room to help her de-stress on 30 hour shifts. It sounds weird, but if it makes it smell or seem a little more like home, it helps it suck a little less.

Hey! I am a junior in high school REALLY looking to go into the medical field (surgery or otherwise). Do you have any courses/videos/documentaries/books you recommend? I'm volunteering at a hospital but I want to learn more :) thank you!!

Hi! Sounds like you have a good idea as to where you looking into and have already gotten off to a good start by volunteering. Now I must say this as a caveat as many others (Wayfairing, Cranquis, etc) have said: don’t forget to be a kid. Yes yes, you’re almost a full-fledged legal adult, but don’t forget to do the fun things of high school and college.

Now that I’ve gotten that disclaimer out of the way, I do have a few recommendations as I was kind of a in a similar situation when I was your age (crap saying that makes me feel old). However, this also depends upon what you’re really looking into. Sounds like you’re big into surgery. I was a trauma nerd from the get-go. These overlap some but I’ll also include more for general purposes, as there are folks interested in other specialties (and just with surgery there are a whole lot of subspecialties).

If you’re not taking an anatomy class already, I recommend that. Look into what your local college/community colleges offer, particularly in anatomy and physiology. I was able to do a cadaver lab dissection as a part of my biology class senior year, which was a really amazing experience.

As far as the internet (which if you’re on here you’re already seeing a lot of the medblr/nurblrs): look into blogs which suit your fancy. Same thing with twitter. A lot of the various med schools and medical groups have very active twitters and this can be a great way to see what the latest and greatest things are that are coming about from research and such. Dr. McGonagall (head of trauma surgery) from Regions Hospital in Minneapolis/St. Paul area has a really active tumblr (regionstraumapro). Lurie Children’s in Chicago and I think it’s UC-San Diego also have active handles. I’m sure there are plenty others that are out there that I haven’t seen yet so consider digging around. I’m also a lover of Dr. Pimple Popper (Sandra Lee) on instagram and youtube. She has some really fascinating cases and loves to talk about them (while she’s excising them).

PBS’s NOVA has a bunch of good shows regarding medical stuff. I have a few favorites which include:

1. “So You Want to Be A Doctor?” – 10 year study where they follow a select group of students at Harvard Med School first starting in the early 90s. There’s another episode in 2001/2002 that’s a follow up with all of the docs. Pretty interesting look into the hell that can be med school and residency and how this affects the lives of doctors and their families for the good and bad.2. “Dying to Breathe” - covers the lives of three people with end stage lung disease waiting for a transplant.3. “Separating Twins” - Two Bangladeshian twins are taken to Australia in efforts to separate them in a really high risk surgery.4. “Vaccines - Calling the Shots” - interesting look at the public health crises and epidemiology regarding vaccinations

PBS’s Frontline also has some good episodes. These are just two that I’ve seen and based upon their episode list, there’s a bazillion more.1. “Hunting the Nightmare Bacteria” – superbugs and how they came about. If this doesn’t terrify you, nothing will.

Nat Geo has one that is my particular favorite called “Chicago Trauma” which highlights the trauma department (from the subsection of the ER dedicated to trauma to their Trauma/SICU). County takes a huge number of GSW and other trauma victims within the city of Chicago and has subsequently developed a really amazing trauma program.

Discovery had a series of shows called “Trauma: Life in the ER” which is all documentary format but goes into various ERs across the country and takes a look at trauma patients as well as regular medicine patients facing emergent situations in the ER.

Other documentaries that I like are Code Black and Baghdad ER. Code Black follows residents in LA County Hospital and the massive issues of overcrowding and charting and such. Baghdad ER follows the crew of US Army ER nurses and docs, surgeons, orthopods, etc working in the middle of Baghdad taking care of wounded GIs and Iraqis alike. Pretty fascinating, albeit very gruesome. Definitely one to watch if you’re a trauma/surgery geek.

As far as some of the fictional ones, I’m always one for the early seasons of ER. They have the intensity but are also (in my opinion) a lot more accurate than the later seasons, and always way more accurate than shows like Grey’s or House. I’m also not a member of The Vagina Squad (OB/GYN) so I can’t attest to the accuracy of the show, but I have always thought Call the Midwife is pretty great, though I do get the feeling that there’s a few too many happy endings at the end of it (not trying to be the black cloud, just trying to be realistic). Amazon has a British series called “London Hospital” which apparently is a kind of flashback series to the British show Casualty (another show which I heard was good back in it’s earlier years).

So as you can see, I clearly watch too much TV :) However, I do think a lot of these are really good things to kind of whet your palate and help you in focusing on what you like. From there I think it’s easy to get into different books and focus. I don’t have many book recommendations as a lot of them can get kind of technical and most of them are nurse-focused, but Trauma Junkie: Memoirs of an Emergency Flight Nurse by Janice Hudson is pretty amazing.

Nurblrs/Medblrs/Pre-Medblrs – reblog and list some of your recommendations!

Hi! I'm currently a medical student, but will be leaving in short because the cost (emotionally, financially, and investment of my time) isn't worth the benefit. I'm starting to explore the options of mid-level practitioners because I don't want to give up the health field completely. What made you decide to go the PA route rather than all of the other options open to you?

Excellent question. For me choosing PA had much to do with investment of time and my desire to have a more meaningful impact on the lives of patients. Prior to PA school I was a 26 year old married x-ray tech who desired a more challenging career and wanted to start a family soon. When I considered my options for advancement the choices were hospital administration, PA school, or medical school. Now I am not particularly skilled at politics or small talk so hospital administration was quickly crossed off my list. The real debate in my mind was PA vs. MD. The table below demonstrates my findings after some research.

In short, I found that a career as a PA will provide me with the mental challenge and job satisfaction I desire while still allowing me to practice before I turn 30. This table is certainly not all inclusive but I found it helpful and maybe you will as well.

we're part of techblr. let's speculate. do you think the whole dating thing is a joke or real?

I don’t think it’s a joke at all to be honest. Of course since this is an anonymous question and it’ll be answered publicly I can’t say anything like “lolz no R u kidding me?” For all I know Steve or Liz could’ve asked me this in the first place!

Anyway I have a lot of confidence in Liz and I definitely remember when she was in the whole online dating search phase(and how much it sucked for the most part, or at least from what she said), so if she finally found someone then FUCK YEAH! Same with Steve, though I don’t know him quite as well (Hi Q2Q, how are ya?). I by no means doubt the formings of a relationship in what seems to us a really short time (*sings “It only takes a moment” in head*, sorry I just finished strike of Hello Dolly!).

That said I saw like one post on the matter, how the hell should I know? I used to tease my friend about being in a relationship with a guy we knew for a long time until BOOM they were in a relationship, and an awesome one at that.

If it is a joke however the whole situation suddenly becomes reminiscent of Medblr’s shipping of Cranquis and WayfaringMD aka Crayfaring.

My first attempt at a Follow Forever!So I’m at over 1100 followers. Thought it was time to do a “Follow Forever”…If you like these things, please click “like” so I know to do another one sometime.

In my job working with animal populations, 12 is the “magic number.” It’s the minimum number of samples you need to submit to a lab for population surveys that result in “pass/fail” of a program. Have a herd of cows and want to know if they have an okay nutrition plan? 12 blood samples minimum. Want to know if your orphaned lambs are getting enough colostrum via your colostrum replacer program? 12 animals and 12 blood samples please.

That’s why I’m listing 12 blogs. These are some of my favorite 12 blogs about animals, vet, or medicine related that I enjoy and reblog a lot from. No particular order. Just some good blogs with nice content. Y’all should follow these guys!